Management of Iatrogenic Atrial Septal Defects in the Era of Large-Bore Transcatheter Mitral Valve Therapies

Cardiovasc Revasc Med. 2021 Oct:31:83-88. doi: 10.1016/j.carrev.2020.11.019. Epub 2020 Nov 21.

Abstract

Several case reports described acute and subacute decompensations that were reversed after percutaneous interatrial septal defect (ASD) closure. At least 30% of patients post MitraClip will continue to have a persistent ASD at 1 year. Few retrospective studies described various echocardiographic associations with persistent ASD but there is no conclusive evidence that it is the cause of a poor outcome. Conclusion: At this time routine closure of ASD post MitraClip is not recommended unless there is hemodynamic decompensation that cannot be explained by other factors.

Keywords: Atrial septal defect; Atrial septal defect closure; Interatrial septal defect; Interatrial septal defect closure; MitraClip.

Publication types

  • Review

MeSH terms

  • Cardiac Catheterization / adverse effects
  • Heart Septal Defects, Atrial* / diagnostic imaging
  • Heart Septal Defects, Atrial* / surgery
  • Humans
  • Iatrogenic Disease
  • Mitral Valve* / diagnostic imaging
  • Mitral Valve* / surgery
  • Retrospective Studies
  • Treatment Outcome